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Which findings have been reported in the literature as benefits of allowing family to be present during resuscitation and invasive procedures? (Selaebcirtb a.clolm t/hteastt apply.)
- A. Families benefit by witnessing that everything possible was done.
- B. Families report reduced anxiety and fear about what is being done to the patient.
- C. Presence encourages family members to seek litigation for improper care.
- D. Presence reduces nurses’ involvement in explaining th ings to the family.
Correct Answer: A
Rationale: Step 1: Families benefit by witnessing that everything possible was done during resuscitation and invasive procedures.
Step 2: This reassures families that healthcare providers are doing their best to save the patient.
Step 3: It can provide closure and comfort to families knowing that all efforts were made.
Step 4: This transparency can also help in the grieving process for families.
Summary: Choice A is correct because it highlights the emotional and psychological benefits for families. Choices B, C, and D are incorrect as they do not align with the positive impacts of allowing family presence during resuscitation and invasive procedures.
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The critical care nurse is responsible for monitoring the patient receiving continuous renal replacement therapy (CRRT). In doing so, the nurse should
- A. assess that the blood tubing is warm to the touch.
- B. assess the hemofilter every 6 hours for clotting.
- C. cover the dialysis lines to protect them from light.
- D. use clean technique during vascular access dressing changes.
Correct Answer: B
Rationale: The correct answer is B because assessing the hemofilter every 6 hours for clotting is essential in ensuring the effectiveness of CRRT. Clotting can obstruct blood flow, leading to treatment inefficiency and potential harm to the patient. This step helps the nurse to promptly address any clotting issues and prevent complications.
A: Assessing that the blood tubing is warm to the touch is not a standard practice for monitoring CRRT and does not provide relevant information about the treatment's effectiveness.
C: Covering the dialysis lines to protect them from light is not a priority in monitoring CRRT. Light exposure is not a common concern in this context.
D: Using clean technique during vascular access dressing changes is important for infection prevention but is not directly related to monitoring the effectiveness of CRRT.
A patient’s status deteriorates and mechanical ventilation i s now required. The pulmonologist wants the patient to receive 10 breaths/min from the ventilaabtirobr.c bomu/tt ewst ants to encourage the patient to breathe spontaneously in between the mechanical breaths at his own tidal volume. This mode of ventilation is referred to by what term?
- A. Assist/control ventilation
- B. Controlled ventilation
- C. Intermittent mandatory ventilation
- D. Positive end-expiratory pressure
Correct Answer: C
Rationale: Rationale:
1. Intermittent Mandatory Ventilation (IMV) allows the patient to breathe spontaneously between the preset mechanical breaths.
2. It provides a set number of breaths per minute while allowing the patient to initiate additional breaths at their own tidal volume.
3. IMV is a partial ventilatory support mode, providing a balance between controlled and spontaneous breathing.
4. Assist/Control Ventilation (A) provides full support with every breath initiated by the patient or the ventilator.
5. Controlled Ventilation (B) does not allow for spontaneous breaths by the patient.
6. Positive End-Expiratory Pressure (D) is a separate mode focusing on maintaining positive pressure at the end of expiration, not providing breaths.
Ideally, by whom and when should an advance directive be developed?
- A. Family, if the patient is in critical condition.
- B. Patient as part of the hospital admission process.
- C. Patient before illness or impairment occurs.
- D. Patient’s healthcare surrogate.
Correct Answer: C
Rationale: Step-by-step rationale for choice C:
1. Advance directives should be made by the patient to reflect their wishes.
2. Developing it before illness ensures clarity and avoids confusion.
3. Patients may not be able to make informed decisions in critical conditions.
4. Family or surrogates may not accurately represent the patient's wishes.
Summary:
A - Family in critical condition may not know the patient's wishes.
B - Hospital admission process may be too late for clear decision-making.
D - Healthcare surrogate may not fully understand the patient's preferences.
Which statement is true regarding the effects of caring for dying patients on nurses?
- A. Attendance at funerals is inappropriate and will only c reate additional stress in nurses who are already at risk for burnout.
- B. Caring for dying patients is an expected part of nursingab airnb.dco wm/itells tn ot affect the emotional health of the nurse if he or she maintains a p rofessional approach with each patient and family.
- C. Most nurses who work with dying patients are able to balance care needs of patients with personal emotional needs.
- D. Provision of aggressive care to patients for whom they believe it is futile may result in personal ethical conflicts and burnout for nurses.
Correct Answer: D
Rationale: The correct answer, D, is supported by the fact that providing aggressive care to patients when nurses believe it is futile can lead to personal ethical conflicts and burnout. This is because nurses may experience moral distress when their values conflict with the care they are providing. This can result in emotional exhaustion and decreased job satisfaction, ultimately leading to burnout.
Choice A is incorrect because attending funerals can be a way for nurses to process their grief and find closure, rather than creating additional stress. Choice B is incorrect because caring for dying patients can have emotional impacts on nurses, regardless of their professional approach. Choice C is incorrect because balancing care needs with personal emotional needs can be challenging and may not always be achievable.
When evaluating a patient with a central venous catheter, the nurse observes that the insertion site is red and tender to touch and the patient’s temperature is 101.8°F. What should the nurse plan to do next?
- A. Give analgesics and antibiotics as ordered.
- B. Discontinue the catheter and culture the tip.
- C. Change the flush system and monitor the site.
- D. Check the site more frequently for any swelling.
Correct Answer: B
Rationale: The correct answer is B: Discontinue the catheter and culture the tip. The patient's symptoms indicate a possible catheter-related infection. Discontinuing the catheter will prevent further infection spread. Culturing the tip will identify the specific pathogen causing the infection, guiding appropriate antibiotic therapy. Choice A is incorrect because giving analgesics alone will not address the underlying infection. Choice C is incorrect as changing the flush system is not a priority when infection is suspected. Choice D is incorrect as checking the site more frequently does not address the need for immediate action to address the infection.